Summary: The objective of this grant application is to create a center to support and expand our ability to conduct full-spectrum clinical and translational research on various cancers. Establishing the Dakota Cancer Collaborative on Translational Activity (DACCOTA) will also allow us for the first time to apply our basic scientific and epidemiologic work to the clinical arena while training clinician-investigator partners to translate these discoveries. We will train basic scientists to conduct translational work, population health experts to understand the community determinants of cancer outcomes, and clinicians to collaborate. The DACCOTA will promote and facilitate interactions between clinicians and scientists with unique but complementary areas of expertise. Our goal is to develop a highly productive, collaborative, and sustainable translational research center that will focus on the cancers that most commonly and disproportionately afflict the citizens of our region, especially American Indians. We have proposed independent cores, all led by capable investigators, that will assist in building a competitive clinical and translational cancer research center. The DACCOTA will provide an academic home for clinical and translational scientists and trainees. These investigators will focus on understanding the mechanisms leading to the initiation and progression of cancer, which will facilitate the development of novel and effective treatments and improve disease surveillance. This is necessary due to the increase in cancer prevalence and mortality in the Dakota region and throughout the USA. The DACCOTA will have further impact by validating new ways of developing and supporting individuals to facilitate team-based science addressing critical issues affecting the region. Our Professional Development Core will develop aspiring investigators and train practicing real world? clinicians to become more avid and effective collaborators. Applicants for pilot grants will be required to propose teams including an investigator and clinician. The Community Enagement and Outreach Core will help recruit volunteers, seek advice about overall directions, and work with community leaders to designate specific cancer-related issues of community concern for RFA?s that will be funneled through the Pilot Projects Program. In addition to the community-based natures of the University of North Dakota (UND), North Dakota State University (NDSU), and the University of South Dakota (USD), the collaborating hospitals in this proposal cover more than 90% of the region and include multiple innovative departments of family and community medicine as well as rural and population health. There are also three MPH programs between these institutions. Thus, we are superbly positioned to conduct clinical research encompassing the entire region. Similarly, the Biostatistics, Epidemiology, and Research Design Core and the Clinical Research Resources and Facilites Core will combine their strengths and develop new resources to enhance clinical research. Finally, our Tracking and Evaluation Core will use innovative methods to evaluate these novel processes as well as provide suggestions to improve efficiency and ensure both cost-effectiveness and improved patient safety. UND, NDSU, USD, and all clinical partners are fully committed to ensuring the growth and sustainability of the DACCOTA even after the CTR grant ends.